Provider Demographics
NPI:1568796860
Name:TAMY E. PERNG, D.O., INC.
Entity Type:Organization
Organization Name:TAMY E. PERNG, D.O., INC.
Other - Org Name:SOUTHWEST SURGICAL SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMY
Authorized Official - Middle Name:ERH-CHIEN
Authorized Official - Last Name:PERNG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:1276-679-2090
Mailing Address - Street 1:98 15TH ST NW
Mailing Address - Street 2:SUITE 206
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-1600
Mailing Address - Country:US
Mailing Address - Phone:276-679-2090
Mailing Address - Fax:276-679-9664
Practice Address - Street 1:98 15TH ST NW
Practice Address - Street 2:SUITE 206
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1600
Practice Address - Country:US
Practice Address - Phone:276-679-2090
Practice Address - Fax:276-679-9664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102202410208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty